MEDICARE: MINDFUL STEPS BEHAVIOR, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1922953272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL STEPS BEHAVIOR, LLC

Provider Business Mailing Address
First Line	:	4456 DENVER ST
Second Line	:
City	:	MONTCLAIR
State	:	CA
Zip	:	91763-3009
Country	:	US
Telephone Number	:	909-684-5975
Fax Number	:

Provider Business Practice Location Address
First Line	:	4456 DENVER ST
Second Line	:
City	:	MONTCLAIR
State	:	CA
Zip	:	91763-3009
Country	:	US
Telephone Number	:	909-684-5975
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	SANDRA QUAM
Credential	:	M.S., BCBA
Telephone Number	:	909-684-5975

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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